An oncology group in Fort Myers, Fla. has agreed to pay more than $2.3 million to settle the federal government's claim that the Department of Veterans Affairs overpaid for drugs.
The VA's Office of Inspector General determined after investigating a whistleblower tip that the VA had been paying Florida Cancer Specialists & Research Institute its full billed amount for physician-administered drugs instead of the appropriate Medicare rate, which is lower.
While most veterans receive care from VA-operated medical facilities, the VA also contracts with non-VA facilities to provide the care. The VA pays outside providers Medicare rates for physician-administered drugs.
Marianne Parker, a claims resolution specialist with FCS, filed a qui tam complaint in a Florida federal court after she discovered the oncology group was being overpaid and reported it to the VA OIG's hotline. After the issue was fixed, the government said it worked cooperatively with FCS to identify the remaining overpayment amounts.
The settlement, announced Tuesday by the Department of Justice, is not a determination of liability. It concludes Parker's lawsuit, and she will receive 20% of the recovery.
"Money designated for the medical care of our veterans is a precious commodity," U.S. Attorney Chapa Lopez said in a statement. "We are pleased that Florida Cancer Specialists cooperated with the investigation and will return the overpayment back to the VA. Any other providers who received such overpayments should follow suit."
Nathan Walcker, FCS' chief financial officer, said in a statement that after the practice was informed that the VA was mistakenly overpaying for certain physician-administered drugs, it worked cooperatively with the government to identify and return the funds.
"Florida Cancer Specialists takes great pride in its long-established history of providing the highest quality, value-based care to patients and will continue to do so for years to come," he said.
David Spilker, special agent in charge of the VA OIG, emphasized that the settlement reinforces his agency's commitment to safeguarding the integrity of the VA's healthcare programs and preserving taxpayer funds for their intended purposes.